COVID-19 vaccine acceptance among people living with HIV: A systematic review and meta-analysis

Abstract

Objective: To assess coronavirus disease 2019 (COVID-19) vaccine acceptance among people living with HIV (PLHIV) worldwide. Methods: We searched MEDLINE, PSYINFO, CINHAL, Scopus and EMBASE databases and other sources including free Google search and subject-specific journals from January 2020 to September 2021. The study population included adults (aged 18+ years) living with HIV and evaluated for COVID-19 vaccine acceptance. A random effect meta-analysis model was used to estimate the pooled COVID-19 vaccine acceptance rate. Subgroup analyses were performed, and factors associated with COVID-19 vaccine hesitancy underwent narrative analysis. Of 558 initial records, 14 studies were eligible for review. Results: The overall pooled COVID-19 vaccine acceptance rate among adult PLHIV was 62% (95% confidence interval [CI], 56%–69%). In subgroup analysis, the estimated pooled COVID-19 vaccine acceptance rate was higher in high-income countries: 63% (95% CI, 55%–70%) versus 62% (95% CI, 54%–71%) in low- and middle-income countries, and in studies conducted in 2022 (66% [95% CI, 58%–75%]) than in studies conducted in 2021 (57% [95% CI, 47%–68%]). Reasons for lower COVID-19 vaccine acceptance included higher monthly income, being non-homosexual, history of chronic disease, COVID-19-related medical mistrust, not knowing anyone who died of COVID-19, believing oneself to be immune to COVID-19, general vaccine refusal, negative attitude to the vaccine, concerns about efficacy, safety and side effects, distrust in common sources of vaccine-related information and using social media as a source of information on COVID-19. Conclusion: Among PLHIV, acceptance of COVID-19 vaccine is generally low. A greater emphasis on collaborative efforts between all concerned bodies is needed to boost vaccine acceptance in this population.